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Recent outcome of liver transplantation for Budd Chiari syndrome - analysis of the european liver transplant registry (ELTR) and affiliated centres
Dongelmans, W; Polak, W; Karam, V et al.
2022In Transplantation, 106 (8S), p. 30-31 (O-047
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Keywords :
greffe; foie; transplantation; result; complication
Abstract :
[en] Background: Maintenance anticoagulation and Transjugular Intrahepatic Portosystemic Shunt (TIPS) have improved management of Budd-Chiari Syndrome (BCS) over the last decades. Most published studies on outcomes of liver transplantation (LT) for BCS in Europe date before these changes. Methods: Data were obtained from the European Liver Transplantation Registry (ELTR). Age <16, secondary BCS and hepatocellular carcinoma were excluded. Patient (PS) and graft survival (GS) before and after 2000 was compared. Multivariate Cox regression analysis (with re-transplantation as time- dependent covariate) identified predictors of PS and GS after 2000. Supplementary data was requested from all ELTR affiliated centres and received from 39. Results: 811 patients were transplanted for primary BCS between 2000 and 2020. Median age was 37.2y, 60% were female, median MELD was 17 and 29% had high urgency (HU) listing. One-, five- and ten-year PS rates between 2000-2020 were 83%, 76% and 69%, compared to 71%, 66% and 61% for the 293 patients transplanted before 2000 (p<0.001), while GS was 78%, 69%, 62% vs. 63%, 58% and 52%, respectively (p<0.001). Since 2000, BCS recurred in 3% and 12% received a re-transplant. Older recipient age (HR 1.02; 95%CI 1.01-1.04) and higher MELD (HR 1.03; 95%CI 1.01-1.06) were associated with worse PS while HU listing was associated with improved PS (HR 0.57; 95%CI 0.35-0.92). Older donor age was the only independent predictor of worse GS (HR 1.01; 95%CI 1.00-1.02). In n=236 (29%) with additional centre-data, 38% had myeloproliferative disease, 25% received TIPS pre-LT and 82% used anticoagulation post-LT. In these, anticoagulation was the only independent factor associated with PS (HR 0.38; 95%CI 0.15-0.98).Conclusions: LT for BCS results in excellent patient and graft survival. Outcomes have improved since 2000. Older recipient age and higher MELD result in poorer survival. HU listing appears to select patients with most favourable outcome. Long-term anticoagulation seems beneficial. Further validation is needed.
Disciplines :
Gastroenterology & hepatology
Surgery
Author, co-author :
Dongelmans, W
Polak, W
Karam, V
Pirenne, J
Acarli, K
Hakeem, A
Dhakshinamoorthy, V
Fedaruk, D
Rummo, O
Kilic, M
Nordin, A
Fischer, L
Parente, A
Mirza, D
Bennet, W
Tokat, Y
Faitot, F
Antonelli, B
Muiesan, P
Nadalin, S
Berlakovich, G
Patch, D
Berrevoet, F
Ribnikar, M
Gerster, T
Savier, E
Gruttadauria, S
Ericzon, BG
Cuervas-Mons, V
Perez Saborido, B
Croner, R
Magini, G
Rossi, R
Popescu, I
Razvan, L
Schneeberger, S
Blokzijl, H
Llado, L
Bravo, MA
Duvoux, C
Mezlijk, V
Oniscu, G
Pearson, K
Dayangac, M
Lucidi, V
Detry, Olivier  ;  Université de Liège - ULiège > Département des sciences cliniques > Pathologie chirurgicale abdominale et endocrinienne ; Centre Hospitalier Universitaire de Liège - CHU > > Service de chirurgie abdo, sénologique, endocrine et de transplantation
Rottellar, F
Darwish Murad, S
More authors (38 more) Less
Language :
English
Title :
Recent outcome of liver transplantation for Budd Chiari syndrome - analysis of the european liver transplant registry (ELTR) and affiliated centres
Publication date :
August 2022
Event name :
2022 Joint International Congress
Event organizer :
ILTS, ELITA & LICAGE
Event place :
Istanbul, Turkey
Event date :
du 4 au 7 mai 2022
Audience :
International
Journal title :
Transplantation
ISSN :
0041-1337
eISSN :
1534-6080
Publisher :
Lippincott Williams & Wilkins, Maryland, United States - Maryland
Volume :
106
Issue :
8S
Pages :
30-31 (O-047)
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 27 August 2022

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